A study in the Journal of Alzheimer's Disease found Alzheimer's to be more common in rural Appalachian Ohio communities than in other rural areas, reports OSU News . Researchers reviewed 11 years of federal Medicare data, ending in 2017, to compare the prevalence of Alzheimer's and related ailments in Appalachian Ohio with other parts of the state. "Those who live in rural Appalachia . . . are both much more disadvantaged on the whole from a socioeconomic perspective and have a higher burden of Alzheimer's disease and related disorders compared to those who live elsewhere," explained OSU Professor Jeffrey Wing. "It's a double whammy." Rural Appalachian counties had a 2 percent to 3 percent higher prevalence of Alzheimer's versus rural non-Appalachian counties. The problem is likely worsened by entrenched barriers to care in the region, especially specialized care. "We're hopeful that this information will help illuminate potential needs in Appalachia — that could include more screenings, earlier screenings, and reallocation of medical and support resources," Wing said.

A study in Orthopedics suggests that reverse total shoulder arthroplasty (RTSA) may benefit people older than 60 with chronic rotator cuff tears without glenohumeral arthritis, reports Healio . "An increasing number of studies support the effectiveness of RTSA in treating older patients who have chronic irreparable rotator cuff tear RCT without arthritis, as measured by a wide number of outcomes, including pain, active forward flexion, and to a lesser extent, external rotation motion," the researchers wrote. The authors analyzed data from a retrospective review between 2007 and 2015 of persons diagnosed without chronic shoulder arthritis, identifying 428,651 individuals with chronic RCT without arthritis; 84.9 percent received nonoperative treatment, 12.5 percent received RCR, and 2.6 percent received RTSA. Subjects between 60 and 79 years old had a 70.8 percent rate of surgical intervention, with 69.2 percent undergoing RCR and 78.4 percent receiving RTSA. A three-fold increase in RTSA use was observed in those 60 or older versus those younger than 60. The overall revision rate at two years was 13 percent for subjects between 60 and 79 years who received RCR compared to people of the same age who underwent RTSA. The researchers noted consistent revision rates over time following RCR, while revision rates for RTSA declined significantly.

Research from Group Risk Development (GRiD) found that employers are more concerned about the health and well-being of baby boomers than they are about any other working generation, reports HR News . They were asked to compare how six areas of health and well-being impact four different generations. Overall, respondents said their biggest concern was boomers' general lack of fitness caused by an inactive lifestyle and sedentary working conditions. Their second most pressing concern for boomers was living with long-term chronic illness or health conditions, like diabetes. The third biggest worry among employers for boomers was poor health related to lifestyle, such as obesity, smoking, and alcohol dependence. Mental health issues among boomers cited by employers include stress and anxiety related to work, home life, and finance and debt. "It's hugely important that employee support is provided holistically with adequate resources split between physical, mental, financial, and social health, as no one can predict the twists and turns that an individual's life may take," said GRiD spokesperson Katharine Moxham. Many employers will find boomers are committed to working for longer than they had perhaps anticipated, while some will be unable to afford retirement.

The ELDERCARE-AF clinical trial evaluated the effect of edoxaban in adults aged 80 years or older with atrial fibrillation (AF) who were not considered eligible for standard oral anticoagulant therapy to prevent stroke, reports the New England Journal of Medicine . Conducted in Japan, the Phase III study included patients with nonvalvular AF. One-half of the participants — 492 — were randomized to edoxaban 15 mg once daily, with the remainder allocated to placebo. The main efficacy outcome was a composite of stroke or systemic embolism, which occurred at an annualized rate of 2.3 percent in the intervention group and 6.7 percent in the control group. Major bleeding—the primary safety endpoint—occurred at an annualized rate of 3.3 percent and 1.8 percent, respectively. The results suggest that once-daily edoxaban was superior to placebo in preventing stroke or systemic embolism in adults aged 80 years and older with nonvalvular AF and did not generate a significantly higher rate of major bleeding than placebo.

A study in Neurology suggests that a group of widely used medications might accelerate mental decline in older adults, especially if they are at increased risk of dementia, according to U.S. News & World Report . Anticholinergic drugs are used to treat a broad range of conditions, including allergies, motion sickness, overactive bladder, high blood pressure, depression, and Parkinson's disease. Healthy older adults on anticholinergics had a higher risk of mild cognitive impairment, with the association strongest among two groups of people already at elevated risk of Alzheimer's disease: those with a gene variant that raises the odds of the disease, and people with certain biological "markers" of the disease in spinal fluid. Professor Allison Reiss at New York University Long Island School of Medicine said the medications block a chemical called acetylcholine, which transmits messages among neurons, and is typically low in people with Alzheimer's. "The preponderance of evidence suggests it's better to avoid these medications in older adults," she explained.

To help voters across the United States get the information they need to vote in this year's election, Axios is launching an interactive resource, based on research by the nonpartisan election reform group RepresentUs. "This election year, voters need to take more time and effort to navigate the challenges of a pandemic," says U.S. Elections Assistance Commissioner Donald Palmer. Early voting will have a greater impact in the event that the election is hampered by problems with the U.S. Postal Service, ballot shortages, confusion, lawsuits, or delays. The state of North Carolina will be the first to send out absentee ballots on Sept. 4, and Minnesota and South Dakota will be the first to let voters cast ballots early in person starting Sept. 18. Meanwhile, voters in Texas, Tennessee, South Carolina, Mississippi, Louisiana, Kentucky, Indiana, and New York require an excuse to vote absentee — although New York is poised to revise that mandate and more may follow. Eleven states require absentee ballots to be notarized, have a witness signature, or be submitted with a copy of an identity — or be rejected. California, Colorado, Hawaii, Nevada, Oregon, Utah, Vermont, Washington, and the District of Columbia are automatically sending voters mail-in ballots in addition to applications. Using early voting options could help limit crowds and long lines on election day, and reduce the risk of coronavirus infections.

According to the Baltimore Sun , city health officials are using a new computer system created by volunteer programmers to keep in touch with senior living communities during crises like hurricanes and the current pandemic. The Code for Baltimore volunteer group worked with government technology development firm Bellese Technologies to develop the system, which automatically emails communities to assess needs and supply information, with capability for texts soon to be added to its repertoire. In its initial weeks, the system has been used to survey senior communities about specific needs related to the pandemic, via e-mail; health department personnel can respond directly to queries or refer them to outside resources. Communities' responses also have alerted officials to residents' loneliness or boredom during quarantine, prompting them to link seniors with electronic devices virtually to outside groups.

A study in Science Advances indicates that problems in spatial navigation are detectable in people with a genetic risk for Alzheimer's disease, reports Technology Networks . Animals and humans are able to follow their own position in space through self-motion cues, even when other sensory information is lacking — a skill called path integration; scientists assume that this ability is governed by the activity of grid cells in the entorhinal cortex. When navigating a spatial environment, these cells exhibit a unique activity pattern, and the entorhinal cortex is one of the first brain regions affected by Alzheimer's. An earlier study showed grid cells' function changes in people at genetic risk for Alzheimer's, although test subjects had no obvious navigation problems. "We assume that they used compensatory mechanisms to find their way, presumably via external cues in their surroundings," said Professor Nikolai Axmacher at Ruhr-Universität Bochum and Universitätsklinikum Freiburg. The new study involved a computerized navigation task in which participants could not use external landmarks. The team compared the navigation performance of 202 volunteers without genetic Alzheimer's risk and 65 volunteers with increased genetic risk who had a specific expression of the gene for apolipoprotein E, the APOE-e4 allele. Participants with a genetic risk of Alzheimer's performed less well than the controls, and further analysis with magnetic resonance imaging found grid cell representations in the entorhinal cortex were associated with navigation without external cues.

A study published in Nature found clear evidence of a direct connection between inflammation and the development of Alzheimer's disease, reports ScienceDaily . A protein known as IFITM3 that plays a role in the immune response to pathogens also is involved in the buildup of beta-amyloid in plaques. The researchers learned that IFITM3 changes the activity of an enzyme called gamma-secretase, which segments precursor proteins into the fragments of beta-amyloid that constitute plaques. The protein's removal decreased the enzyme's activity, and reduced the number of plaques that formed in a mouse model of Alzheimer's. The implication of these findings is that viral and bacterial infections could elevate the risk of Alzheimer's development, as the concentration of IFITM3 in human brain samples correlated with levels of certain viral infections and with gamma-secretase activity and beta-amyloid production. Moreover, the levels of both inflammatory markers and IFITM3 rose with advancing age in mice. In addition, IFITM3 increased in a subset of late onset Alzheimer's patients, suggesting the protein could find use as a biomarker to identify a subset who might benefit from therapies that target it.

Some 300 researchers have authored a letter to U.K. Science Minister Amanda Solloway, urging the British government to prevent a major setback in the search for new dementia treatments because of the COVID-19 pandemic, reports Medical Xpress . With the backing of Alzheimer's Research UK and the Alzheimer's Society, the signatories warn that lost funding opportunities could lead to a lost generation of researchers, jeopardizing the future of dementia research. The British medical research sector expects a £310 million gap in charity funding due to the pandemic, with medical research charities predicting an average 41 percent plunge in research spending for 2020-2021. Dementia researchers fear this could imperil critical progress in recent years, with the danger that many scientists may have to abandon dementia research completely. Concurrently, people with dementia are being battered by COVID-19, with 25 percent of all COVID-19 deaths in England and Wales occurring among those with dementia. "We are asking the government to continue its support for this growing field by delivering on its Manifesto commitment to double the dementia research budget, which will unlock new funding to enable early-career researchers to remain in a field where so much progress is urgently needed," the letter's signers wrote.